動機與目的：隨著疾病型態轉變、社會文化變遷與資通訊科技進步，疾病共同照護模式的發展與探討顯得愈發重要。本研究目的在比較三種冠心病照護模式對病患自我照護成效。方法：研究對象為南部某醫學中心之心臟科門診篩選有冠心病的患者。本研究採實驗性設計，先以隨機分派方式，分派至實驗組與對照組，再依病患意願，立意分派至整合性照護組與遠距健康照護組，其中，整合性照護組有128人，遠距健康照護組有47人，對照組有93人，總計268人。研究追蹤期間共計一年。研究結果採用廣義估計方程式，以評估介入後的成效分析。結果：經由統計分析結果顯示，以三組照護模式及照護模式加介入期間後進行分析，遠距照護模式呈現統計顯著照護效果，另兩組則無統計顯著差異。進一步檢視介入期間後的變化差異，顯示包括疾病認知與生活品質、醫療照護需要、部分生化指標、自我照顧能力等皆呈現統計上有顯著改善。結論：透過本研究結果顯示，遠距健康照護模式對冠狀動脈心臟病患者是有顯著成效，且在照護模式中比其他組別提供更完整的健康管理，包括增加病患對疾病的認知、自我照護能力方面都能提升。本研究並依此結果提出研究建議，以作為未來發展冠心病整合照護服務的參考依據。 Background and Research purpose: With the prevalence of chronic disease; transformaton of social-cultural change; and the progress of information communication technology in Taiwan, it has an urge for the exploration and development of integrated healthcare with chronic disease. Our research purpose is to compare the effectiveness of shared care model for patient’s health promotion with cardiovascular disease.Methods: The research subject are recruited from a department of cardiogy in a medical center in southern Taiwan. We designed an experimental research with randomized assignment on both two experiment groups and the control group. Furthermore, a purpose assignment was carried out for the two experimental groups by the willingness to join of participants. A total of 268 participants were validated into the research and assigned to integrated care group by 128 participants, to telehealthcare group by 47 participants, and comparison group by 93 participants. The research participants were followed by one year. We used generalized estimating equation to analyze and compare the research results.Results: The research tests the effectiveness between three groups and three time infervals. On the effectiveness of research groups, the telehealthcare group shows statistically significant comparing to the comparison group. On the effectiveness of three time intervals, the telehealthcare group show statistically significant on the perception of Cardiovascular disease, perceived life quality, need for medical care services, partly biochmical indicators, and capability on self care.Conclusion: Our study shows that telehealthcare services can provide a better quality of care for patients with Cardiovascular disease and make a significantly improvement on their perception and self care at home. To conclude, this research provide some research suggestions for the future development of integrated healthcare servies with coronary heart disease.
